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原位肝移植术后转移性黑色素瘤一例。

A Case of Metastatic Melanoma Post Orthotopic Liver Transplantation.

作者信息

Ortiz Muriel Samantha, Mohammed Rahed, Bass Kathryn, Gopinath Prathima, Manasia Anthony

机构信息

Institute for Critical Care Medicine, Mount Sinai Hospital, New York, USA.

出版信息

Cureus. 2024 May 15;16(5):e60347. doi: 10.7759/cureus.60347. eCollection 2024 May.

Abstract

With the rising prevalence of organ transplantation, clinicians must be aware of the many potential complications that may arise. One such complication is post-transplantation melanoma. Herein, we present a case of advanced metastatic melanoma following orthotopic liver transplantation (OLT).  This is a 54-year-old cirrhotic male who underwent OLT that was complicated by metastatic melanoma. Despite adherence to yearly screening guidelines and timely radiation and immunotherapy, the disease course was rapidly progressive and fatal. This case aims to highlight the risk of post-transplantation melanoma and the potential need for screening modifications to identify melanoma earlier in its development.  The association between organ transplantation and melanoma is well-reported, but the underlying risks and mechanisms remain incompletely understood. One potential risk factor is post-transplant immunosuppressive therapy, which may result in fatally aggressive melanoma. Understanding the potential mortality risks in transplant patients, modifications to peri-transplant screening guidelines, and immunosuppressive therapy may be lifesaving.

摘要

随着器官移植患病率的上升,临床医生必须意识到可能出现的许多潜在并发症。其中一种并发症是移植后黑色素瘤。在此,我们报告一例原位肝移植(OLT)后发生的晚期转移性黑色素瘤病例。这是一名54岁的肝硬化男性,接受OLT后并发转移性黑色素瘤。尽管遵循了年度筛查指南并及时进行了放疗和免疫治疗,但疾病进程迅速进展并导致死亡。本病例旨在强调移植后黑色素瘤的风险以及可能需要修改筛查方法以便在黑色素瘤发展早期进行识别。器官移植与黑色素瘤之间的关联已有充分报道,但潜在风险和机制仍未完全明确。一个潜在风险因素是移植后免疫抑制治疗,这可能导致极具侵袭性的致命黑色素瘤。了解移植患者的潜在死亡风险、修改移植围手术期筛查指南以及免疫抑制治疗可能会挽救生命。

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